Assistant Manager - Credentialing

Location: Mohali

1. Reports to the Director of Credentialing & Contracting:
Provide regular updates on the team's performance, including key metrics, achievements, and any areas needing improvement
If the team is working on specific projects, the manager will keep the director informed of progress, milestones, and any potential roadblocks
Regularly report on the team's progress towards set goals and objectives, ensuring they align with the overall organizational strategy
Swift reporting of challenges or issues that the team is facing, such as resource constraints, conflicts, or technical problems
Make recommendations to the director on how to improve performance, optimize processes, or address issues
Report on team morale, individual performance within the team, and any training or development needs

2. Manage Payer Enrollment Process:
Ability to complete, coordinate and audit provider applications and credentialing packets for provider
Ensure all necessary documentation (licenses, certifications, malpractice insurance, etc.) is up to date and submitted

3. Maintain Compliance:
Stay updated on payer requirements and government regulations (e.g., CMS, state Medicaid programs)
Ensure timely recredentialing and re-enrollment to avoid gaps in coverage or billing disruptions

4. Team Oversight:
Assists in creating a supportive and flexible environment that encourages communication and feedback, as well as modeling and promoting healthy work habits
Supervise a team of Team Leads, Credentialing Specialists, Coordinators and Trainees
Develop and implement policies, procedures, and timelines to streamline the enrollment process
Ensures the processes and measures are in place to monitor and guide employee performance and activities
Work Closely with those tasked as trainers to make sure that measures, and requirements are successfully met

5. Payer Relations:
Serve as the liaison between providers and insurance companies
Follow up on escalated applications and troubleshoot any issues or delays

6. Database and System Management:
Maintain accurate records in credentialing or enrollment databases (e.g., CAQH, PECOS, Availity)
Generate reports and track status of applications and expirations

7. Cross-Department Coordination:
Work closely with internal company department heads to ensure providers are enrolled and credentialed before they begin billing claims (billing/onboarding)

Job Requirements

• Strong knowledge of US healthcare and insurance company requirements.

• Understanding of multiple provider specialties and facilities

• Familiarity with credentialing software and systems

• Organizational and multitasking abilities

• Strong leadership skills

• Excellent written and oral English communication skills

• Positive team player attitude

• Strong analytic and reporting skills

• Highly proficient with computers, especially Word and Excel

• Ability to work in night shifts

Shifts :
Night Shift (7:30 pm – 4:45 am) Monday to Friday
Salary :
Commensurate with experience

Employment Type

:
Permanent Job, Full Time
Industry :
Healthcare IT, IT Software, Software Services
Role Category :
Healthcare Data, Electronic Health Record (EHR) Implementation
Work Location : A303 Bestech Business Tower, Sector-66, Mohali, Punjab

Bikram Gill – HR Director
Email :
Phone :